A Single-Arm, Dose Escalation of an Intraurethral Alprostadil Paste for Erectile Dysfunction

Official title

Phase 2 Clinical Trial of ST-04 Intraurethral Paste for Erectile Dysfunction

Overview

This is a single arm dose escalation trial of a mucoadhesive intraurethral polymer suspension of alprostadil (ST-04) and will investigate the efficacy of 3 dose levels of ST-04 in adult males with a clinical diagnosis of Erectile Dysfunction (ED). This study aims to determine if ST-04, with or without sildenafil, will improve erectile function (EF) compared to baseline. Participants in this study will receive ST-04, a new formulation containing the vasodilator, alprostadil which is known to be an effective drug in treating erectile dysfunction. ST-04 will be dispersed along the urethra, forming a hydrogel which adheres to the lining of the urethra with the goal of penile tumescence and erection. Participants may receive up to 3 dose level escalations of ST-04 over a 12-week period, for a total of up to 11 administrations of ST-04. Dose escalation may also be done with and without sildenafil.

Interventions

• Drug ST-04
  ST-04 consists of an alprostadil polymer suspension designed for intraurethral application

Primary outcome measures

• Change from Baseline in the Erectile Function Domain of the IIEF Questionnaire [Time frame: From baseline to 1 month after start of the last dose level (Week 4, 8, 12 respectively)]

Secondary outcome measures (4)

• Change from Baseline in the Erectile Hardness Scale (EHS) [Time frame: From baseline to the end of treatment at week 4, 8 or 12 respectively]
• Change from Baseline in the Sexual Encounter Profile (SEP) [Time frame: From baseline to the end of treatment at week 4, 8 or 12 respectively]
• Percentage of Uses per Participant of ST-04 which Led to the Onset of Erection within up to 30 minutes of Application per Number of Intercourse Attempts [Time frame: From baseline to the end of treatment at week 4, 8 or 12 respectively]
• Incidence and Severity of Adverse events [Time frame: From baseline to the end of treatment at week 4, 8 or 12 respectively]

Eligibility criteria

Inclusion criteria

• Have had a confirmed clinical diagnosis of ED for more than three months based upon IIEF
• Have failed PDE5 inhibitor therapy (inability to achieve an erection with adequate rigidity to allow penetrative sex)
• Ability to take oral medication (sildenafil) and be willing to adhere to the study intervention regimen
• Engaged in heterosexual relationship with partner for a minimum of 6 months

Exclusion criteria

• History of unstable medical or psychiatric condition that, in the opinion of the principal investigator, could impact the patient's ability to complete the study investigations or protocol.
• Spinal cord injury, or penile anatomical abnormalities
• Cardiovascular conditions that prevent sexual activity (NYHA Class II or higher, any angina, or uncontrolled CHF or severe coronary artery disease)
• History of myocardial infarction, stroke, or life-threatening arrhythmia within 6 months prior to enrollment into the study
• Use of anti-androgens, or oral or injectable androgens
• Documented hypotension or known orthostatic hypotension
• Use of oral, topical or sublingual nitrates within 3 months prior to enrollment into the study
• Hepatic (Child-Pugh Class C) or renal failure (eGFR < 30)
• Inadequate response to intracavernosal injection therapy previously
• Peyronie's disease or Meatal stenosis

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Treatment

Study locations

Canada · 1 center

• Vancouver Prostate Centre — Vancouver

Identifiers

NCT: NCT07601646 · H25-00542

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗